Attacking cancer at the molecular level

Aaron Derfel, THE GAZETTE01.19.2014

Research technician Junhui Liu works on DNA samples in the tissue preparation laboratory at the new Molecular Pathology Centre of the Jewish General Hospital on Tuesday, Jan. 14.Dario Ayala
/ The Gazette

Molecular pathology DNA samples are stored in a refrigerator in the tissue preparation laboratory at the new Molecular Pathology Centre of the Jewish General Hospital.Dario Ayala
/ The Gazette

Research technician Junhui Liu shows a plastic test tube with DNA from a patient, seen in white at the bottom of the tube, as he works in the tissue preparation laboratory at the new Molecular Pathology Centre of the Jewish General Hospital on Tuesday, Jan. 14.Dario Ayala
/ The Gazette

“I think it’s wonderful that they can zoom in on cancer this way,” says patient Michel Slakmon.Dario Ayala
/ The Gazette

MONTREAL - The walls are painted lime green, red and royal blue, and employees can write on some of them if they so choose, as if this work space were a lab straight out of Google.

It’s no coincidence that the Molecular Pathology Centre at the Jewish General Hospital is inspired by Google’s design esthetic.

Dr. Alan Spatz, director of the centre that opened in November, said he wanted to create an environment for scientific research, teaching and clinical care where unconventional thinking thrives, where medical students are free to ask “naive questions” that could lead to breakthroughs in treatments for many types of cancer, and eventually, for cardiovascular and neurodegenerative diseases.

“What is so unique about this place is the synergy,” he said, alluding to the collaboration that goes between oncologists, drug developers, pathologists, cell biologists, data managers and genomics specialists — all of whom work at the centre.

Funded entirely by private donations, the $8-million centre houses next-generation gene-sequencing and other equipment, some of which are prototypes from manufacturers. Affiliated with the Jewish General’s Segal Cancer Centre, Spatz’s lab also has an international research mandate, seeking partnerships on studies with American and European scientists.

The typical pathology lab contains rows of microscopes and tissue slides. The Jewish General is not abandoning such traditional pathology, but taking it to the next level. Technicians and scientists collect the tissue samples, extract the DNA and perform dozens of tests at once, searching for hidden genetic defects that might have caused someone’s cancer.

The results gleaned from these tests give oncologists a complete picture of the patient’s illness. The physicians will then know from the start which treatments will succeed in an individual and which will fail, sparing the patient unnecessary suffering and saving the health-care system unnecessary expense.

Michel Slakmon, a 64-year-old Côte-Saint-Luc resident, lost his voice in June 2012. At the Jewish General, a CT scan revealed that he had an advanced form of lung cancer.

A generation ago, oncologists would have treated someone in Slakmon’s condition exclusively with chemotherapy and radiotherapy — hoping for the best — without knowing the exact molecular pathology of his cancer. In Slakmon’s case, doctors at the Jewish General discovered that his lung cancer was ALK-positive, revealing a particular type of genetic defect.

They knew from the outset that Slakmon would probably respond well to a new biologically-based drug, Crizotinib, after he underwent the standard cycles of chemotherapy and radiotherapy. Sure enough, within two days of taking the pill, Slakmon’s tumours started shrinking.

But not all lung-cancer patients will respond to Crizotinib, and that’s why a molecular pathology centre is so essential. And that’s why Spatz suggests that a greater understanding of genetics has ushered in a true age of “personalized medicine.”

“I think it’s wonderful that they can zoom in on cancer this way,” Slakmon said during a visit to the centre this week.

Unfortunately, Slakmon’s cancer has started growing again, but his doctor has informed him that there is a new treatment available — a drug that will target his cancer in a way that conventional chemotherapy could never do.

“What we want to achieve here,” Spatz said, “is a seamless integration between pathology and oncology. We’re just so excited to be doing all this.”

*******

The Molecular Pathology Centre won’t become fully operational until later this year, but it has already attracted some renowned scientists from around the world. Among them:

Alan Spatz, a pathologist and director of the centre, had served as head of a lab at the Gustave Roussy Cancer Institute in France.

Leon van Kempen, the centre’s chief operations officer, was formerly co-director of the “X chromosome and cancer” research lab at Nijmegen university in The Netherlands.

Hangjun Wang, a pathologist specializing in breast and lung tumours, worked at Memorial Sloan-Kettering Cancer Center in New York

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